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AB1111 A prospective cohort study measuring cost-benefit analysis of the otago exercise programme in community dwelling adults with rheumatoid arthritis
  1. S Abdulrazaq1,
  2. T O'Neill2,
  3. EK Stanmore3,
  4. J Oldham1,
  5. D Skelton4,
  6. M Pilling5,
  7. B Gannon1,
  8. C Todd1
  1. 1School of Nursing, Midwifery and Social Work and MAHSC
  2. 2School of Medical Sciences
  3. 3School of Nursing, University of Manchester, Manchester
  4. 4University of Glasgow, Glasgow
  5. 5University of Manchester, Manchester, United Kingdom

Abstract

Background Falls are one of the major health problems in adults with Rheumatoid Arthritis (RA). Interventions, such as the Otago Exercise Programme (OEP), can reduce falls in community dwelling adults by up to 35%. The cost-benefits of such a programme in adults with RA have not been studied

Objectives To determine healthcare cost of falls in adults with RA, and estimate whether it may be cost efficient to roll out the OEP to improve function and prevent falls in adults living with RA.

Methods Patients with Rheumatoid Arthritis aged ≥18 years were recruited from four rheumatology clinics across the Northwest of England. Participants were followed up for 1 year with monthly fall calendars, telephone calls and self-report questionnaires. Estimated medical cost of a fall-related injury incurred per-person were calculated and compared with OEP implemention costs to establish potential economic benefits.

Results 535 patients were recruited and 598 falls were reported by 195 patients. Cumulative medical costs resulting from all injury leading to hospital services is £ 374,354 (US$540,485). Average estimated cost per fall is £ 1120 (US$1617). Estimated cost of implementing the OEP for 535 people is £ 116,479 (US$168,504) or £ 217.72 (US$314.34) per-person. Based on effectiveness of the OEP it can be estimated that out of the 598 falls, 209 falls would be prevented. This suggests that £ 234,583 (US$338,116) savings could be made, a net benefit of £ 118,104 (US$170,623).

Conclusions Implementation of the OEP programme for patients with RA has potentially significant economic benefits and should be considered for patients with the disease.

References

  1. Stanmore EK, Oldham J, Skelton DA, O'Neill T, Pilling M, Campbell AJ, et al. Fall incidence and outcomes of falls in a prospective study of adults with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2013;65(5):737–44.

  2. Stanmore EK, Oldham J, Skelton DA, O'Neill T, Pilling M, Campbell AJ, et al. Risk factors for falls in adults with rheumatoid arthritis: a prospective study. Arthritis Care Res (Hoboken). 2013;65(8):1251–8.

  3. Hayashibara M, Hagino H, Katagiri H, Okano T, Okada J, Teshima R. Incidence and risk factors of falling in ambulatory patients with rheumatoid arthritis: a prospective 1-year study. Osteoporos Int. 2010;21(11):1825–33.

  4. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.

  5. Gardner MM, Robertson MC, Campbell AJ. Exercise in preventing falls and fall related injuries in older people: a review of randomised controlled trials. British Journal of Sports Medicine. 2000;34(1):7–17.

  6. Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc. 2002;50(5):905–11.

References

Acknowledgements Special thanks to all the participants involved in the research and also the nursing staff who supported the data collection phase of the study at Manchester Academic Health Science Centre (MAHSC).

Disclosure of Interest None declared

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